Labor Department Releases New FMLA Model Forms and Notice Poster
Source: Jackson Lewis
The U.S. Department of Labor has released revised model Family and Medical Leave Act (“FMLA”) forms to administer federal FMLA leave and a notice poster. The updated forms should be used by employers immediately, although they include no substantive revisions despite recent rule-making on the FMLA military caregiver leave provisions (see our article DOL Publishes Final Regulations Addressing Military Family Leave Provisions). The new forms expire on February 28, 2015. Following are links to the revised model forms:
- WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition
- WH-380-F Certification of Health Care Provider for Family Member’s Serious Health Condition
- WH-381 Notice of Eligibility and Rights & Responsibilities
- WH-382 Designation Notice
- WH-384 Certification of Qualifying Exigency For Military Family Leave
- WH-385 Certification for Serious Injury or Illness of Covered Service member — for Military Family Leave
- WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave
Employers should keep in mind that family and medical leave obligations under state/territorial laws may provide for a greater leave entitlement than the FMLA and (most notably in California, Connecticut and Washington, D.C.) require employers to provide other forms or information.
The DOL notice poster summarizes major provisions of the federal FMLA and tells employees how to file a complaint. By March 8, 2013, all covered employers must display the new notice poster in a conspicuous place where employees and applicants for employment can see it. The poster must be displayed at all locations even if there are no employees eligible for FMLA at the location (e.g., there are fewer than 50 employees employed within a 75-mile radius of the worksite). Electronic posting also is permitted to satisfy the posting requirement, as long as it otherwise meets the requirements of the regulations.
The poster may be accessed here: http://www.dol.gov/whd/regs/compliance/posters/fmlaen.pdf